Fighting fire with fire: Combating burnout among medical educators

June 25, 2019

Physicians are reporting emotional exhaustion, depersonalization, and decreased accomplishment. 

Physicians can take steps to avoid burnout, including leaving their work in the office, not bringing it home to the family, and disconnecting for a time from email and patient charts. 

Reviewed by Joan M. O'Brien, MD

Burnout among educators occurs in 40% to 45% of physicians who report emotional exhaustion, depersonalization, or a decreased sense of accomplishment.

However, these feelings do not exist in a vacuum. Medical errors, physician suicide, and depression are serious consequences.

Joan M. O’Brien, MD, advised that physicians start by taking a look inward.

Dr. O’Brien is the William F. Norris and George E. de Schweinitz professor, chair of ophthalmology, University of Pennsylvania, and director, Scheie Eye Institute, Philadelphia.

Dr. O’Brien advised that physicians should live in the moment, which can be achieved both by leaving their work in the office and not bringing
it home to the family. This can start by putting down the phone or computer. Disconnect for a time from email, and patient charts.

Just say no

Sometimes, physicians have to consider themselves, and another step in caring for oneself is learning that sometimes you have to say “no.”

“Success does not mean accepting every request,” Dr. O’Brien pointed out. “Learn to selectively say ‘yes.’”

RELATED: Mentoring ophthalmology’s leaders of tomorrow takes structure, goals

Share your thoughts

Further, she pointed out, by sharing thoughts, burnout and exhaustion can be destigmatized, and physicians can receive the support that they may need.

“We need supportive mentors in all aspects of our lives,” Dr. O’Brien said. “Learn to ask for help, advice, or resources, when needed.”

Another option is to create a caring work environment by supporting colleagues, and students.

“Giving more results in receiving more,” she noted.

Learn about yourself

Dr. O’Brien recounted her personal experience with mitigating burnout as an oncology intern early in her medical career.

In her close relationships with an educator and a student, Dr. O’Brien explained that she was able to learn her limitations in caring for seriously ill patients.

Dr. O’Brien ultimately decided to switch her specialty from oncology to ophthalmology.

“I needed to change course,” she explained. “As leaders and faculty, when we feel burned out there comes a moment when we need to talk with our chairman, and change direction.”

Physicians should be able to recognize the signs of burnout among students and residents, and support the promotion of a positive, open learning environment.

“Fostering an environment of belonging can result in reduced rates of attrition in a surgical residency program,” Dr. O’Brien said.

RELATED: Ophthalmologists called upon to help impaired colleagues

Early career issues

Higher rates of burnout have been reported in residents, fellows, and physicians early in their careers. Medical students have also been shown to have higher rates of depression than students in other disciplines. Solving the issues, in many instances, can start at the top.

“By securing our own well-being, we can ensure that trainees are not experiencing burnout,” Dr. O’Brien said.

What to avoid and what to do
For Dr. O’Brien, there are some “never” actions that she takes care to avoid because they commodify physicians.

Specifically, she never uses the word “provider” in place of the word “physician.” While it is a small thing, it can go a long way in valuing physicians.

Dr. O’Brien advised that physicians should live in the moment, which can be achieved both by leaving their work in the office and not bringing it home to the family. This can start by putting down the phone or computer. Disconnect for a time from email, and patient charts.

RELATED: A fresh set of eyes

Show appreciation

On the flip side of the coin, she has pursued actions that include always appreciating individuals around her, particularly educators.

Dr. O’Brien also makes an effort to recognize and call out noteworthy educational comments during grand rounds.

It also is important to provide financial incentives for teaching and citizenship from medical centers, and philanthropists, apply for teaching awards for faculty members through societies and universities among others, and support the Academy of Master Clinicians and Educators by advising faculty members to join.

Dr. O’Brien also advocates running frequent team building events promoting transparency of expectations about teaching. She also suggests identifying physician educators.

Openly value their work in academia to ensure that they become role models, and mentors. They will be positioned to educate the next generation of ophthalmologists well, and with enthusiasm. 

Disclosures:

 

Joan M. O'Brien
E: obrienjo@pennmedicine.upenn.edu
Dr. O'Brien has no financial interest in any aspect of this report.